Individual
TED W ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3611 22ND PL, LUBBOCK, TX 79410-1317
(806) 799-7928
(806) 788-8560
Mailing address
3509 22ND ST, LUBBOCK, TX 79410-1307
(806) 799-7928
(806) 788-8560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D3127
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130248107
—
TX
01
—
D3127
LICENSE
TX
Enumeration date
07/27/2006
Last updated
10/06/2017
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